Adherence to the Mediterranean Diet and Its Association with Cognitive Function in Children and Adolescents: A Systematic Review of Observational Studies

Objectives: This study aimed to analyze the associations between cognitive functions and adherence to the Mediterranean diet (MedDiet) in children and adolescents. Methods: A systematic review was conducted in three databases: Pubmed, Scopus, and Web of Science. The inclusion criteria of the studies were (i) population: healthy children or adolescents; (ii) exposure: adherence to the MedDiet; (iii) outcomes: cognitive performance; and (iv) study design: observational studies only. The quality of the studies was assessed through the Newcastle-Ottawa Scale. Results: This systematic review included 12 cross-sectional, observational studies including a total of 6378 children aged 4-17 years from different countries, analyzing diet characteristics and cognitive functions. The quality of the studies was high (Newcastle-Ottawa Scale mean score = 7.42). Positive associations were found between adherence to the MedDiet and multiple cognitive functions: memory, attention, creativity, language skills, and executive functions. However, the wide variety of instruments assessing the adherence to the MedDiet and cognitive functions did not allow us to perform a meta-analysis. Conclusions: The MedDiet should be further considered and promoted among children and adolescents, as it shows promise as a dietary pattern that may support cognitive development in youth.